3270.21 · Conditions at the facility may not pose a threat to the health or safety of the children.

In Room 003 adult scissors. a stapler, a stapler remover, and boxes of thumb tacks were observed inside an unlocked drawer accessible to children in care; a lock was on the drawer however it was broken and would not engage to prevent from opening.

Corrected Corrected by Jan 21, 2025

Category: health medication. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services). A facility person's record shall include a copy of requests for the criminal history record and child abuse registry clearance information, a copy of the disclosure statement and a copy of the completed clearance information required under the CPSL.

The staff file for Staff person #1 was observed to lack a valid Child Abuse clearance; the clearance on file was a volunteer clearance which is not acceptable for employment purposes per the Child Protective Service Law (CPSL). Staff person #1 also lacked a valid FBI clearance on file at time of hire; a clearance was on file, but it was not a DHS FBI clearance as required by the CPSL.

Corrected Corrected by Jan 30, 2025

Category: background checks. Marked corrected in the state record.

3270.65 · Protective receptacle covers shall be placed in electrical outlets accessible to children 5 years of age or younger.

In Room 003 an electrical outlet located to the left of the kitchen play area, which is accessible to children 5 years of age or younger, was observed to lack one protective outlet cover.

Corrected Corrected by Jan 21, 2025

Marked corrected in the state record.

3270.66(a) · Cleaning materials and other toxic materials shall be kept in an area or container that is locked or made inaccessible to children.

In Room 003 a bottle of Advil and an Elta MD skincare product both labeled 'Keep Out of Reach of Children' was observed inside an unlocked drawer accessible to children in care; a lock was on the drawer however it was broken and would not engage to prevent from opening.

Corrected Corrected by Jan 21, 2025

Marked corrected in the state record.

3270.106(f) · At least 2 feet of space is required on three sides of a bed, cot, crib or other rest equipment while the equipment is in use.

At approximately 12:30pm in Room 101B the following mats were observed to not have at least 2ft of space on 3 sides while in use: a young toddler was observed sleeping on mat that was placed 10inches from a shelving unit, and two infants were observed sleeping on mats that had 10 inches between them and were placed an inch from the wall. At approximately 2:30pm during naptime in Room 108 and in Room 001, multiple mats were observed to lack at least 2ft of space on 3 sides while in use during naptime.

Corrected Corrected by Jan 21, 2025

Category: physical safety. Marked corrected in the state record.

3270.113(a) · Children on the facility premises and on facility excursions off the premises shall be supervised by a staff person at all times. Outdoor play space used by the facility is considered part of the facility premises.

At approximately 12:30pm in Room 101B two infants were observed sleeping on mats that were on one side of a room divider that had a toy shelving unit on the opposite side obstructing the view of the two staff who were on the opposite side of the room divider and they could not adequately see and assess those two sleeping infants. At approximately 2:30pm during naptime in Room 001 and in Room 002, depending on where staff were positioned in the room, they could not adequately supervise some of the napping children due to multiple pieces of furniture obstructing the Staff's ability to see and assess those children who were napping.

Corrected Corrected by Jan 22, 2025

Category: supervision. Marked corrected in the state record.

3270.131(b)(2) · The operator shall require the parent to provide an updated health report at least every 12 months for an older toddler or preschool child.

The child file for Child #1, who is a preschool age child, was observed to contain an updated health report dated 7/22/24 which was conducted more than 12 months from the previously dated 5/12/23 health report on file. The child file for Child #2, who is a preschool age child, was observed to contain an updated health report dated 4/5/24 which was conducted more than 12 months from the previously dated 3/17/23 health report on file.

Corrected Corrected by Jan 21, 2025

Category: health medication. Marked corrected in the state record.

3270.133(5) · Medication shall be stored in accordance with the manufacturer's or health professional's instructions on the original label.

In Room 101A an infant Tylenol and Little Remedies saline spray were both observed to have expired as of 10/2024.

Corrected Corrected by Jan 21, 2025

Category: health medication. Marked corrected in the state record.

3270.151(a) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem.

The staff file for Staff person #2, contained a current health assessment dated 10/7/24 which was conducted more than 24 months from the previously dated 9/29/22 health assessment on file.

Corrected Corrected by Jan 30, 2025

Category: ratio. Marked corrected in the state record.

3270.27(a)(6) · Emergency drills shall be conducted annually. Annual emergency drills shall be documented and on file at the facility.

An annual emergency drill was observed to be conducted on 11/14/24 which was more than 12 months after the previously documented emergency drill dated 3/29/23.

Corrected Corrected by Jan 21, 2025

Category: recordkeeping. Marked corrected in the state record.

3270.20(a)(1) · The operator shall immediately notify a child's parent and shall telephone notice to the appropriate regional office within 24 hours if a child in care at the facility is hospitalized or receives emergency room treatment.

During an incident investigation conducted on 10/22/24 it was determined that on 9/27/24 Child #1 had a seizure and was taken to the emergency room, and the facility did not notify the western region office of the incident until 10/4/24.

Corrected Corrected by Oct 28, 2024

Category: physical safety. Marked corrected in the state record.

3270.20(b) · The operator shall mail or deliver a written report to the appropriate regional office within 72 hours after hospitalization of a child in care, emergency room treatment of a child in care, death of a child in care, a facility fire requiring the services of a fire department.

During an incident investigation conducted on 10/22/24 it was determined that on 9/27/24 Child #1 had a seizure and was taken to the emergency room, and the facility did not submit a written report of the incident to the western region office until 10/4/24.

Corrected Corrected by Oct 28, 2024

Category: physical safety. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The file for staff person #6 was observed to lack documentation of completion of the following pre-service training by December 30, 2022: Pennsylvania Health and Safety Update 2022

Corrected Corrected by Feb 1, 2024

Category: ratio. Marked corrected in the state record.

3270.27(c) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility.

The two most recent emergency plan trainings documented in the files for staff persons #3, #7, and #11 are dated more than 12 months apart. Staff person #3: 7/14/22 and 8/30/23. Staff person #7: 3/3/22 and 8/30/23. Staff person #11: 5/19/22 and 8/30/23. The file for staff person #9 has documentation of emergency plan training dated 8/30/23 but was not at the time of initial employment (See LIS Code Sheet).

Corrected Corrected by Jan 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.32(a)/3270.192(4) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for staff person #9 had documentation of FBI clearance dated 4/7/23, which was after the staff person's start date (See LIS Code Sheet).

Corrected Corrected by Jan 25, 2024

Category: background checks. Marked corrected in the state record.

3270.32(a)/3270.192(2)(iii) · The operator shall comply with the CPSL and with Chapter 3490 (relating to protective services).

The file for staff person #10 had documentation of Mandated Reporter training that was not renewed before the expiration date of the most current certification: 8/28/18 and 9/14/23.

Corrected Corrected by Jan 25, 2024

Category: ratio. Marked corrected in the state record.

3270.75(c) · A first-aid kit must contain the following: soap, an assortment of adhesive bandages, sterile gauze pads, tweezers, tape, scissors and disposable, nonporous gloves.

The first aid kit in Room 001 did not include tweezers.

Corrected Corrected by Jan 25, 2024

Category: health medication. Marked corrected in the state record.

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

In Room 004, several of the large, soft, padded shapes of the children's play equipment was observed to be tearing and were not in good repair.

Corrected Corrected by Jan 25, 2024

Category: physical safety. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The emergency contact form in the file for child #2 did not include the enrolling parent's work address.

Corrected Corrected by Jan 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.124(e) · A written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency shall be displayed conspicuously in every child care space and shall accompany a staff person who leaves on an excursion with children.

In Room 009-Front, a written plan identifying the means of transporting a child to emergency care and staffing provisions in the event of an emergency was not posted in a conspicuously location.

Corrected Corrected by Jan 25, 2024

Category: transportation. Marked corrected in the state record.

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The emergency contact and financial agreement forms in the file for child #1 was updated by the parent on 1/26/23 and 8/2/23, which was more than 6-months apart.

Corrected Corrected by Jan 25, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.151(a)/3270.192(3) · A facility person providing direct care who comes into contact with the children or who works with food preparation shall have a health assessment conducted within 12 months prior to providing initial service in a child care setting and every 24 months thereafter. A health assessment is valid for 24 months following the date of signature, if the person does not contract a communicable disease or develop a medical problem. A facility person's record shall include a written report of initial and subsequent health assessments, including the results of initial and subsequent tuberculin skin tests, x-rays or other medical documentation necessary to confirm freedom from communicable tuberculosis.

The two most recent health assessments in the files for staff persons #1 and #8 exceeded 24 months between assessments. Staff person #1: 3/22/21 and 7/21/23. Staff person #8: 8/23/21 and 9/20/23.

Corrected Corrected by Jan 25, 2024

Category: ratio. Marked corrected in the state record.

3270.31(e) · A staff person shall obtain an annual minimum of 12 clock hours of child care training.

The files for staff persons #1, #2, #4, and #5 did not include documentation of a minimum of 12 annual clock hours of child care training for the last full year of employment. Staff person #1 had 8 annual hours documented. Staff person #2 had 9 annual hours documented. Staff person #4 had 11 annual hours documented. Staff person #5 had 9 annual hours documented.

Corrected Corrected by Feb 19, 2024

Category: recordkeeping. Marked corrected in the state record.

3270.102(a) · Toys, play equipment and other indoor and outdoor equipment used by the children shall be clean, in good repair and free from rough edges, sharp corners, pinch and crush points, splinters and exposed bolts.

There was a cracked toy bin in the play kitchen area in Room 108.

Corrected Corrected by Mar 1, 2023

Category: physical safety. Marked corrected in the state record.

3270.123(a)(5) · An agreement shall specify the persons designated by a parent to whom the child may be released.

There were no release persons listed on the most recent agreement in the file for child #4

Corrected Corrected by Mar 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(b)(2) · Emergency contact information must include the name, address and telephone number of the child's physician or source of medical care.

The most recent emergency contact information in the file for child #3 did not include a city or zip code for the child's physician.

Corrected Corrected by Mar 27, 2023

Category: health medication. Marked corrected in the state record.

3270.14/3270.21 · A facility shall be operated in conformity with applicable Federal and State laws and regulations.State agencies whose regulations may relate to the operation of a facility include the Department of Environmental Resources, the Department of Labor and Industry, the Department of Health, the Department of Education and the Department of Transportation. Conditions at the facility may not pose a threat to the health or safety of the children.

The facility's emergency plan did not include information regarding continuity of operations. The facility's shaken baby polciy did not include informations regarding the identification of child maltreatment.

Corrected Corrected by Mar 21, 2023

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(i) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification.

The file for staff person #4 included a provisional FA/CPR certificate that had expired 9/22/22. The individual did not complete the second part of the training.

Corrected Corrected by Feb 7, 2023

Category: ratio. Marked corrected in the state record.

3270.31(e)(4)(ii) · Staff persons shall participate, at least annually, in firesafety training conducted by a fire protection professional. Staff persons and volunteers shall receive training in maintenance of smoke detectors, the duties of facility persons during a fire drill and during a fire and the use of the facility's fire extinguishers, not including discharge of the fire suppressant agent.

The first fire safety training in the file for staff person #2, hired 12/4/20, was dated 8/31/22. last two fire safety trainings in the file for staff person #3 were dated 8/19/21 and 8/30/22. The last two fire safety trainings in the file for staff person #4 were dated 8/29/21 and 8/31/22. The last two fire safety trainings in the file for staff person #5 were dated 8/30/21 and 8/31/22

Corrected Corrected by Mar 21, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.31(f) · Staff persons shall complete professional development within 90 days of hire as listed in subsections (f)1-10.

The health and safety training in the file for staff person #1, hired 8/2/22, was 11/16/22. The individual was suspended from 9/14/22 and 11/2/22, but returned without the training being completed.

Corrected Corrected by Mar 27, 2023

Category: health medication. Marked corrected in the state record.

3270.34(a)(6) · A director is responsible for written evaluation of staff persons on a regular basis, a minimum of one evaluation every 12 months.

The last two evaluations in the file for staff person #5 were dated 4/16/21 and 5/23/22. The last two evaluations in the file for staff person #6 were dated 4/16/21 and 5/23/22. Neither were signed/dated by the director. Based on conversation with the director, they review all staff evaluations, but did not document the reviews.

Corrected Corrected by Mar 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.82(h) · A facility person and an able child shall wash his hands after toileting and before eating. A sign on which this requirement is written shall be posted at each toilet, training chair, diapering area and sink in the facility.

There were no handwashing signs at the 3 toilets in the "preschool potty" bathroom. The restroom in Room 009 did not have a handwashing sign above one of the toilets.

Corrected Corrected by Mar 27, 2023

Category: health medication. Marked corrected in the state record.

3270.124(b)(3) · Emergency contact information must include the home and work addresses and telephone numbers of the enrolling parent.

The most recent emergency contact information in the file for child #3 did not include a city or zip code for the enrolling parent's home and work address.

Corrected Corrected by Mar 27, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.124(f)/3270.181(c) · The parent shall update in writing emergency contact information once in a 6-month period or as soon as there is a change in the information. A parent is required to review and update the emergency contact information and the financial agreement at least once in a 6-month period or as soon as there is a change in the information.

The last two reviews in writing by a parent on the emergency contact information and agreement form in the file for child #2 were 12/14/21 and 7/22/22. The last two reviews in writing by a parent on the emergency contact information and agreement form in the file for child #3 were 12/16/21 and 8/9/22.

Corrected Corrected by Mar 1, 2023

Category: recordkeeping. Marked corrected in the state record.

3270.131(c) · A health report must be written and signed by a physician, physician's assistant or a CRNP. The signature must include the individual's professional title.

The most recent health report in the file for child #1 did not include the name or title of the individual who completed the form. The only information listed was "Nurse CCP BW."

Corrected Corrected by Mar 1, 2023

Category: health medication. Marked corrected in the state record.

3270.133(2) · A staff person shall administer a prescription medication only if written instructions are provided from the individual who prescribed the medicine. Instructions for administration contained on a prescription label are acceptable.

There were no written instructions for the inhaler belonging to child #5

Corrected Corrected by Mar 27, 2023

Category: ratio. Marked corrected in the state record.

3270.62(b) · Outdoor or indoor play space shall be measured at 65 square feet per child

At approximately 10:30 am, staff person #1 and #2 were observed in the indoor gross motor space with 10 preschooler. Some children were eating and some children were playing. As a gross motor space, the room measures for 5 children. As a child care space, it measures for 6 children. Based on staff interviews, over the last week, between 4 and 10 preschool children were being cared for in the indoor gross motor space

Corrected Corrected by Aug 17, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.94(a)(2) · The Director or designated staff person who is responsible for compliance with this chapter shall conduct fire drills and ensure that fire drills are conducted at different times of the day or night, or both, if applicable.

Based on review of the facility's fire drill log, all fire drills conducted in 2022 occurred between 9:30 am and 11 am.

Corrected Corrected by Aug 31, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.95(a)/3270.95(b) · Fire detection devices or systems must be in compliance with standards established under section 1016(c) of the act (62 P.S. §  1016(c)).The Director or designated staff person who is responsible for compliance with this chapter shall ensure the requirements under subsection (a) are met.

The facility does not have verification of the purchase of the fire alarm system installed in the facility, as required per Act 62.

Corrected Corrected by Apr 13, 2022

Category: recordkeeping. Marked corrected in the state record.

3270.27(c)/3270.192(2)(iii) · The operator shall assure that each facility person receives training regarding the emergency plan at the time of initial employment, on an annual basis and at the time of each plan update. The operator shall document the date of each training and the names of all facility persons who received the training and kept on file at the facility. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The most recent emergency plan training on file for Staff person #4 is dated 11/1/21, more than 1 year after the previous training, dated 1/7/20,

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

3270.31(e)(4)(i)/3270.192(2)(iii) · Competence is the completion of training by a professional in the field of first-aid and cardiopulmonary resuscitation (CPR). All staff persons shall renew their certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) on or before the expiration of the most current certification. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The first aid and CPR certification on file for Staff #3, with a hire date of 8/17/21, does not indicate it was pediatric first aid and CPR, as required to be completed within 90 days of hire, as required by the current regulations. The file for Staff #5, with a hire date of 5/3/21, does not include pediatric first aid and CPR certification, as required to be completed within 90 days of hire, as required by the current regulations.

Corrected Corrected by Feb 2, 2022

Category: ratio. Marked corrected in the state record.

3270.69(b) · Hot water temperature, in areas accessible to children, may not exceed 110° F.

The hot water at the sink where children wash their hands in Room 003 measured 111 degrees Fahrenheit.

Corrected Corrected by Feb 2, 2022

Category: physical safety. Marked corrected in the state record.

3270.133(6) · A parent shall provide written consent for administration of medication or a special diet.

There was Tylenol in Room 106 labeled for use by a child that did not have written parental consent to administer.

Corrected Corrected by Feb 2, 2022

Category: ratio. Marked corrected in the state record.

3270.151(c)(3) · An adult health assessment must include an examination for communicable diseases and the results of that examination.

The current health assessment on file for Staff person #1 indicates that she has a contagious or communicable disease, with no further information given.

Corrected Corrected by Jan 26, 2022

Category: health medication. Marked corrected in the state record.

3270.31(e)/3270.192(2)(iii) · A staff person shall obtain an annual minimum of 12 clock hours of child care training. A facility person's record shall include verification of child care experience, education and training following the outset of service at the facility.

The file for Staff person #2, with a hire date of 11/17/20, does not include 12 hours of annual training between 12/19/20-12/19/21, as required per Announcement C-21-09.

Corrected Corrected by Mar 8, 2022

Category: recordkeeping. Marked corrected in the state record.